Treatment disparities between heterosexual and gay and bisexual men diagnosed with prostate cancer.

[Darryl]

The following is part of next week's American Society of Clinical Oncology Annual meeting and was published in the Journal of Clinical Oncology. Malecare found significant treatment utilization disparities between heterosexual and MsM. Most startling is that almost twice as many initially treated heterosexuals navigate towards advanced stage treatment as do MsM.

Treatment disparities between heterosexual and gay and bisexual men diagnosed with prostate cancer.

Sub-category:

Advanced Disease

Category:

Genitourinary (Prostate) Cancer

Meeting:

2016 ASCO Annual Meeting

J Clin Oncol 34, 2016 (suppl; abstr e16548)

Author(s): Darryl Mitteldorf; Malecare Cancer Support, New York, NY

Abstract:

Background: Prostate Cancer treatment types are varied, with choice making conducted within the doctor-patient dyad. This study is the first to identify which treatments heterosexual and Gay and Bisexual men (MsM) choose throughout the disease progression spectrum. Methods: 780 men (632 = Heterosexual, 148 = MsM) completed an online survey during summer of 2015. The men were randomly selected from a national Prostate Cancer support network. We asked about treatments they used during the prior six months and most recently. Combination treatments were treated as a single variable. Results: In general, heterosexual men use more advanced-stage treatments than MsM, while MsM use more early-stage treatments than heterosexuals. For treatments used 6 months prior to survey: 1. Heterosexuals reported a mean of 1.27 advanced-stage treatments, while MsM reported a mean of 0.48 (difference = 0.79). 2. MsM reported a mean of 0.38 early-stage treatments, while heterosexuals reported a mean of 0.24 (difference = 0.14). For most recent treatments: 1. Heterosexuals reported a mean of 1.19 advanced-stage treatments, while MsM reported a mean of 0.54 (difference = 0.65). 2. MsM reported a mean of 0.87 early-stage treatments, while heterosexuals reported a mean of 0.56 (difference = 0.31). Heterosexuals used an average of .65 more treatments during the prior 6 months (p < .0001, 95% Confidence interval: [.38, .91]) and an average of 34 more recent treatments (p = .00013, 95% Confidence interval: [.17, .52]), than did MsM. Regarding the proportion of participants who took both early- and advanced-stage treatments in the last 6 months: Of heterosexuals who reported using early-stage treatments, 39% also reported taking one or more advanced-stage treatment, compared to only 21% for MsM (p < .05). Additional demographics (age, race, etc) and HRQoL questions were asked but provided no significance. Conclusions: We found significant treatment utilization disparities between heterosexual and MsM. Most startling is that almost twice as many initially treated heterosexuals navigate towards advanced stage treatment as do MsM.

[pjoshea13]

Darryl,

Could the results reflect a difference in screening patterns? More screening means more GS=3+3, most of which would not progress.

-Patrick

[Darryl Partner in reply to pjoshea13]

Screening patterns is a realm for further investigation. This study did not look at that. Indeed, this study will provoke many questions and investigations.

[cfrees1]

What are considered "early stage" treatments and what are considered "advanced stage" treatments? This report kind of confuses me as to the conclusions they reach.

[Darryl Partner in reply to cfrees1]

This report did not reach a "conclusion." It merely identified a disparity issue which we hope will lead the way to more practical understanding of prostate cancer.

[cfrees1]

At the end of the report: "Conclusions: We found significant treatment utilization disparities between heterosexual and MsM. Most startling is that almost twice as many initially treated heterosexuals navigate towards advanced stage treatment as do MsM."

I found that confusing, what are they implying? That since gay men have less advance treatments, their cancer is not as likely to advance as your topic headline suggests?n Perhaps is the topic headline that I find confusing.

[Darryl Partner]

The statement in the abstract seems clear, just as you report it. I can see how you (and possibly others) might be confused by the topic headline. I will rewrite that...thanks for your comment.